Feeding practices and growth among low-income Peruvian infants: a comparison of internationally-recommended definitions.

BACKGROUND: Data from a longitudinal study of 153 low-income Peruvian infants were used to assess the relationship between internationally-recommended definitions of feeding practices and infants' monthly weight gain and weight status at 12 months. METHODS: Infants were classified into feeding categories using monthly reported data. Analysis of variance was used to assess the relationship between reported usual feeding practices and growth. Reported breastfeeding practices were compared to observed breastfeeding practices and to weighted breast milk intakes to determine the validity of recommended breastfeeding definitions. RESULTS: Breastfed infants who consumed non-human milks during the first month of life gained less weight during that month (P < 0.002) than exclusively and predominantly breastfed infants. Reported daily nursing frequency was associated with observed nursing frequency and breast milk energy intake (P < 0.05) for infants < 9 months old. Patterns of growth varied according to early diets. Infants who consumed breast milk and non-human milks and those who were fully weaned by 4 months were more likely to be underweight at 12 months than other infants. Infants classified as token breastfeeders ( < or = 3 times/24 hours) from 0 to 120 days had monthly gains that were similar to those of fully weaned infants. CONCLUSIONS: Infants feeding definitions should 1) continue to differentiate exclusively breastfed infants from other infants who are almost exclusively or predominantly breastfed; 2) distinguish partially breastfed infants who consume only non-breastfeeding frequency or the % of their total daily energy that comes from breast milk.

[Tolerance and digestibility of Peruvian "common foods" in malnourished infants]. / "Alimentos comunes" peruanos. Tolerancia y digestibilidad en infantes desnutridos.

Six diets were prepared based on commonly used Peruvian foods, mainly of vegetable origin, which were offered to eight infants (mean age: 12.8 +/- 8.2 months) recovering from malnutrition. The purpose of this study was to evaluate the acceptability, tolerance and digestibility of the diets in question. Five were prepared with a potato and wheat base (noodle) and the sixth with a quinua-oats base. The acceptability and tolerance was satisfacotry, allowing maintenance of an adequate calorie and protein intake in all patients except one. On the quinua-oats based diet, the mean apparent absorption of nitrogen and fat was significantly lower (P less than 0.05) than in the case of the other diets. The increase in height coefficient (height age/chronological age X 100) and weight/age proved to be adequate during the study, except in the three youngest patients. The authors consider that this type of diets (potato-wheat based) can be recommended for infant feeding after the first year of life, and that the quinua-oats based diet still needs a more thorough evaluation prior to recommending its use.

Effect of the level of dietary protein intake on fat absorption in children.

The quantity and quality of protein in the diet affect both nitrogen balance and energy utilization in man. One possible mechanism is by a direct effect on the process of fat digestion and absorption. The effect on fat absorption of feeding diets providing 0%, 6.4%, or 12.5% of energy as protein was assessed in nine children. Liquid diets were prepared by high speed blending of calcium caseinate, a soy-cottonsed oil blend (80:20), sucrose, water, vitamins, and a mineral mixture and fed by bottle five times per day. Diets varied in the amount of protein and were fed to maintain constant the intakes of fat and carbohydrate. All children began by consuming the diet providing 6.4% of energy as protein for a period of 6 days: 3 days of adaptation, 3-day dietary periods and metabolic collections followed in one of two sequences: 12.5%, 0%, 6.4% energy as protein in five children; 0%, 12.5%, 6.4% energy as protein in four. Mean fat excretion during the two 6.4% periods did not differ significantly (initial 14.5 +/- 6% of intake; final, 11.7 +/- 5.0% of intake). Fat excretion was significantly greater during the period when no protein was consumed (23.9 +/- 7.7% of intake) than during either the period in which protein provided 6.4% of energy (P less than 0.01) or during that in which protein provided 12.5% of energy (10.0 +/- 2.6% of intake, P less than 0.001). The difference between the 6.4% and 12.5% periods did not attain significance (P = 0.10). Fecal fat expressed as a percentage of fecal dry weight was significantly greater during periods when the diet contained no protein than during periods in which protein provided either 6.4% (P less than 0.05) or 12.5% (P less than 0.01) of energy. Additional studies were carried out in a similar fashion in six children consuming diets in which protein provided 5%, 9.6%, and 15% of energy. All six possible dietary sequences were used. At these intakes fat excretion did not vary significantly with protein intake.